Notice of Privacy Practices
Effective Date: June 7, 2023

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

I. My Pledge Regarding Health Information

At Sow and Reap Therapeutic Services, PLLC, I understand that your health information is personal, and I am committed to protecting it. I create a record of the care and services you receive to provide you with quality care and comply with legal requirements. This notice describes the ways I may use and disclose your health information, as well as your rights and my obligations regarding its use and disclosure.

I am required by law to:

• Make sure your health information is protected.

• Provide you with this notice describing my legal duties and privacy practices.

• Follow the terms of this notice.

II. How I May Use and Disclose Health Information

The following categories describe the ways I may use and disclose health information without your specific authorization. Not every use or disclosure is listed, but all are within these categories.

1. For Treatment
   I may use or disclose your health information to provide you with treatment or services. For example, I may consult with another healthcare provider about your care.

2. For Payment
   I may use and disclose your health information so I can bill and receive payment for the treatment and services you receive. For example, I may share information with your insurance company to verify your coverage.

3. For Health Care Operations
   I may use and disclose your health information to operate and improve my practice. For example, I may use information to review the quality of my services.

4. To Comply with the Law
   I will disclose your health information when required by federal, state, or local laws.

5. Public Health and Safety
   I may disclose your health information to public health authorities for reasons such as preventing disease, reporting abuse or neglect, or reducing serious threats to anyone’s health or safety.

6. Law Enforcement and Legal Proceedings
   I may disclose health information for law enforcement purposes or in response to valid legal requests, such as court orders or subpoenas.

7. Workers’ Compensation
   I may disclose health information for workers’ compensation or similar programs.

III. Uses and Disclosures Requiring Your Authorization

For certain uses and disclosures, I will obtain your written authorization. Examples include:

• The use of psychotherapy notes.

• Marketing purposes.

• Sale of health information.

If you provide authorization, you may revoke it in writing at any time, except to the extent that I have already acted based on it.

IV. Your Rights Regarding Your Health Information

You have the following rights regarding your health information:

1. Right to Inspect and Copy
   You may request access to your health records and obtain a copy of the information. Fees may apply for copying and mailing.

2. Right to Request Corrections
   If you believe information is incorrect or incomplete, you may request a correction. I may deny your request under certain circumstances.

3. Right to Request Restrictions
   You may ask me to limit the use or disclosure of your health information for treatment, payment, or healthcare operations. I am not required to agree to your request but will comply when possible.

4. Right to Request Confidential Communications
   You may request that I contact you in a specific way or at a specific location, such as only at your home or by mail.

5. Right to an Accounting of Disclosures
   You may request a list of disclosures made of your health information, excluding those for treatment, payment, or healthcare operations.

6. Right to a Paper Copy of This Notice
   You may request a paper copy of this notice, even if you have agreed to receive it electronically.

V. Changes to This Notice

I reserve the right to change this notice and make the revised notice effective for all health information I maintain. If changes are made, the updated notice will be available at my office and on my website.

VI. Acknowledgment of Receipt

You will be asked to acknowledge that you have received this notice. This acknowledgment will be documented at your first appointment.

Contact Information
If you have questions about this notice or need more information, please contact:

Sow and Reap Therapeutic Services, PLLC
600 W 6th St, Suite 467
Fort Worth, TX 76102
Email: sowandreaptherapeuticservices@preciouslpc.com
Telephone: 682-273-0775

Complaints
If you believe your privacy rights have been violated, you may file a complaint with me or with the Secretary of the U.S. Department of Health and Human Services. I will not retaliate against you for filing a complaint.